RN Detained and Quarantined As Ebola Hysteria Reaches a New Low

[MissyWrite]

NJ and NY have instituted a policy of placing health workers into mandatory 21-day quarantine upon their return from West Africa if they came into contact with Ebola patients.

This new policy is a reaction to unfounded public hysteria surrounding Dr. Craig Spencer's return to NYC after working with Doctors Without Borders, and his subsequent diagnosis of Ebola, after he had taken the subway and gone bowling. People fear Ebola can be spread through casual contact with an asymptomatic person, even though public health experts say there's plenty of scientific evidence indicating that isn't the case.

Is this policy based on the facts about Ebola transmission? Is it based on science? No, it's not, and in fact no one is saying that it is:

"Voluntary quarantine is almost an oxymoron," New York Governor Andrew Cuomo said. "We've seen what happens. ... You ride a subway. You ride a bus. You could infect hundreds and hundreds of people."

"Public health experts say there's plenty of scientific evidence indicating that there's very little chance that a random person will get Ebola, unless they are in very close contact -- close enough to share bodily fluids -- with someone who has it.

Still, there's also a sense that authorities have to do something because of Americans' fears -- rational or not -- and belief that the country is better off being safe than sorry.

Osterholm says, "You want to try to eliminate not just real risk, but perceived risk."

Mike Osterholm is an infectious disease epidemiologist at the University of Minnesota.

Because of this irrational "perceived" risk, Kaci Hickox, 33, an RN who has been caring for Ebola patients while on assignment with Doctors Without Borders in Sierra Leone, was detained at the airport, interrogated for hours, and placed in mandatory quarantine at a New Jersey hospital upon her return to the U.S. on Friday.

She has tested negative in a preliminary test for Ebola, and she does not have a fever, but the hospital says she will remain under mandatory quarantine for 21 days. She is not allowed to leave the hospital, unless officials reconsider that decision.

Here are some excerpts from her experience so far:

I am a nurse who has just returned to the U.S. after working with Doctors Without Borders in Sierra Leone - an Ebola-affected country. I have been quarantined in New Jersey. This is not a situation I would wish on anyone, and I am scared for those who will follow me...

I arrived at the Newark Liberty International Airport around 1 p.m. on Friday, after a grueling two-day journey from Sierra Leone. I walked up to the immigration official...

I told him that I have traveled from Sierra Leone and he replied, a little less enthusiastically: "No problem. They are probably going to ask you a few questions."...

He put on gloves and a mask and called someone. Then he escorted me to the quarantine office a few yards away. I was told to sit down. Everyone that came out of the offices was hurrying from room to room in white protective coveralls, gloves, masks, and a disposable face shield.

One after another, people asked me questions. Some introduced themselves, some didn't. One man who must have been an immigration officer because he was wearing a weapon belt that I could see protruding from his white coveralls barked questions at me as if I was a criminal.

Two other officials asked about my work in Sierra Leone. One of them was from the Centers for Disease Control and Prevention.

I was tired, hungry and confused, but I tried to remain calm. My temperature was taken using a forehead scanner and it read a temperature of 98. I was feeling physically healthy but emotionally exhausted.

Three hours passed. No one seemed to be in charge. No one would tell me what was going on or what would happen to me.

I called my family to let them know that I was OK. I was hungry and thirsty and asked for something to eat and drink. I was given a granola bar and some water. I wondered what I had done wrong.

Four hours after I landed at the airport, an official approached me with a forehead scanner. My cheeks were flushed, I was upset at being held with no explanation. The scanner recorded my temperature as 101. The female officer looked smug. "You have a fever now," she said. I explained that an oral thermometer would be more accurate and that the forehead scanner was recording an elevated temperature because I was flushed and upset.

I was left alone in the room for another three hours. At around 7 p.m., I was told that I must go to a local hospital. I asked for the name and address of the facility. I realized that information was only shared with me if I asked.

Eight police cars escorted me to the University Hospital in Newark. Sirens blared, lights flashed. Again, I wondered what I had done wrong.

At the hospital, I was escorted to a tent that sat outside of the building. The infectious disease and emergency department doctors took my temperature and other vitals and looked puzzled. "Your temperature is 98.6," they said. "You don't have a fever but we were told you had a fever."

After my temperature was recorded as 98.6 on the oral thermometer, the doctor decided to see what the forehead scanner records. It read 101. The doctor felts my neck and looked at the temperature again. "There's no way you have a fever," he said. "Your face is just flushed."

My blood was taken and tested for Ebola. It came back negative........

http://www.dallasnews.com/ebola/headlines/20141025-uta-grad-isolated-at-new-jersey-hospital-as-part-of-ebola-quarantine.ece

This is what happens to nurses when public ignorance and hysteria is placated by politicians.

We've already seen nurses blamed for just about everything Ebola-related since the first case in Dallas, and now we see a nurse being held against her will, for no reason except to make scared people "feel safer."

"It does present serious civil liberties questions," said Norman Siegel, a civil liberties lawyer in New York and the former executive director of the New York Civil Liberties Union. "Historically, we've had these kinds of issues occur previously, and the courts then resolved the individual liberty issue against the larger concerns of the public's health concerns. So it then becomes a factual issue, the fact that she tested negative."

"It's completely unnecessary," said Harvard's Ashish Jha, the director of the Harvard Global Health Institute).

"I'm a believer in an abundance of caution but I'm not a believer of an abundance of idiocy."

[Horseshoe, BSN, RN]

The medical screening, which applied to everyone with her recent exposure background, occurred at the end of the customs process, which can be lengthy, and occurred about 4 hours after the wheels of her planed touched down. Her temp of 101 may well have occurred as a result of her impatience, but as far as I know there aren't exception to the screening process that takes into account variations based of the person's personality, and I'm not sure there really should be. The protocols also count a single high temp as a positive trigger for further evaluation/containment since it's not all that unusual for those with a viral infection in the early stages to have a labile temperature, sometimes only spiking for short periods.

There's certainly an argument to be made against the necessity of the level of quarantine that was used initially, but I don't agree with the argument that there was no need to initiate at least some sort of screening and monitoring measures.

The reports I read said that her initial temperature was normal, yet she was detained for several more hours. The second temp scan was high. Once she got to the hospital, she was tested again with an oral thermometer and was WNL that time and every time afterwards.

[Horseshoe, BSN, RN]

I guess I'm still not getting the argument, should her initial fever have been ignored? It would be nice if there was some way to rule out ebola in it's early stages, but there isn't. She was found to not have ongoing symptoms concerning for ebola, but was never ruled out for ebola.

I don't think there's any arguing the accuracy of the forehead thermometers, but none-the-less it's been the standard for mass ebola screening for some time now.

Her initial temperature was normal. Why was that ignored? Why was she further detained?

[BostonFNP, APRN]

The medical screening, which applied to everyone with her recent exposure background, occurred at the end of the customs process, which can be lengthy, and occurred about 4 hours after the wheels of her planed touched down. Her temp of 101 may well have occurred as a result of her impatience, but as far as I know there aren't exception to the screening process that takes into account variations based of the person's personality, and I'm not sure there really should be. The protocols also count a single high temp as a positive trigger for further evaluation/containment since it's not all that unusual for those with a viral infection in the early stages to have a labile temperature, sometimes only spiking for short periods.

There's certainly an argument to be made against the necessity of the level of quarantine that was used initially, but I don't agree with the argument that there was no need to initiate at least some sort of screening and monitoring measures.

From her statement:

"I am a nurse who has just returned to the U.S. after working with Doctors Without Borders in Sierra Leone - an Ebola-affected country. I have been quarantined in New Jersey. This is not a situation I would wish on anyone, and I am scared for those who will follow me.

I am scared about how health care workers will be treated at airports when they declare that they have been fighting Ebola in West Africa. I am scared that, like me, they will arrive and see a frenzy of disorganization, fear and, most frightening, quarantine.

I arrived at the Newark Liberty International Airport around 1 p.m. on Friday, after a grueling two-day journey from Sierra Leone. I walked up to the immigration official at the airport and was greeted with a big smile and a "hello."

I told him that I have traveled from Sierra Leone and he replied, a little less enthusiastically: "No problem. They are probably going to ask you a few questions."

He put on gloves and a mask and called someone. Then he escorted me to the quarantine office a few yards away. I was told to sit down. Everyone that came out of the offices was hurrying from room to room in white protective coveralls, gloves, masks, and a disposable face shield.

One after another, people asked me questions. Some introduced themselves, some didn't. One man who must have been an immigration officer because he was wearing a weapon belt that I could see protruding from his white coveralls barked questions at me as if I was a criminal.

Two other officials asked about my work in Sierra Leone. One of them was from the Centers for Disease Control and Prevention. They scribbled notes in the margins of their form, a form that appeared to be inadequate for the many details they are collecting.

I was tired, hungry and confused, but I tried to remain calm. My temperature was taken using a forehead scanner and it read a temperature of 98. I was feeling physically healthy but emotionally exhausted.

Three hours passed. No one seemed to be in charge. No one would tell me what was going on or what would happen to me.

I called my family to let them know that I was OK. I was hungry and thirsty and asked for something to eat and drink. I was given a granola bar and some water. I wondered what I had done wrong.

Four hours after I landed at the airport, an official approached me with a forehead scanner. My cheeks were flushed, I was upset at being held with no explanation. The scanner recorded my temperature as 101.

The female officer looked smug. "You have a fever now," she said.

I explained that an oral thermometer would be more accurate and that the forehead scanner was recording an elevated temperature because I was flushed and upset.

I was left alone in the room for another three hours. At around 7 p.m., I was told that I must go to a local hospital. I asked for the name and address of the facility. I realized that information was only shared with me if I asked.

Sent from my iPhone.

[amoLucia]

Of all those in the general public who responded as to favoring quarantining of returning HCWs, I wonder how many of them have CLOSE family (ie spouse, child, parent, sibling, next-door-neighbor, etc) who are HCWs? How would they react if that loved one had to spend some 3 weeks in quarantine even if they never demonstrated any disease before or after?

And for that matter, how many of the nurses here on AN (who favor quarantine) would also allow themselves to be quarantined as a matter of course just for doing their jobs?

Could any of them mange the 3 weeks of disruption to heir lifestyles? Who will do 3 weeks of childcare? Will they miss 3 weeks of school?

Any takers?

[Mulan]

No opinion one way or the other, just an observation.

I find it interesting that the doctors come back and do it and don't complain.

Stanford doctor in Ebola quarantine in Bay Area - SFGate

"Dr. Colin Bucks hasn’t had close physical contact with another human being since Sept. 21 and he won’t for another two weeks, when his quarantine period ends after his return from the Ebola front lines in Liberia.

He arrived shortly after news broke that a doctor returning from West Africa had been diagnosed with Ebola in New York City, and just hours before a nurse flew into Liberty International Airport in Newark, N.J., and was forcibly quarantined for several days.

He talked to San Mateo County public health officials and agreed to quarantine himself — a decision he’d already made while he was still working in Liberia.

I miss my family,” Bucks, 43, said Thursday from his Redwood City home. “But we recognized in advance that it would be essential to be separated on the return. It’s an extension of the deployment to me."

[macawake, MSN]

Well, that's his choice and he's certainly free to make it. What's important to me is that people aren't forced to quarantine when there's no scientific rationale that supports such a decision. The doctor recognizes that he isn't infectious but seems to be feel it's acceptable to remain in his house in order to not risk anxiety in his community.

I don't necessarily agree, but it is his choice to make.

Ebola: Stanford doctor back from Liberia has no qualms with quarantine - San Jose Mercury News

He has no symptoms and believes he poses no health risk to his community.

If I had to go outside the house, it would be completely safe. But for community reassurance, I'm staying completely inside my house and on the property, Bucks, a clinical assistant professor of surgery at the Stanford School of Medicine, said in a phone interview Thursday. I wouldn't want anything to happen that would heighten community anxiety.

Doctors like him who work with Ebola are experts on how to contain it, he said. Without symptoms, the Ebola virus cannot be "shed" or transmitted, he said. The more symptoms, he said, the higher potential for spreading the virus.

Even if someone first spikes a fever, the amount of virus is still low and difficult to transmit, Bucks said. It's most concentrated in blood, urine and feces and we think less so in respiratory secretions. With mild symptoms, there's a low viral load, and with no symptoms, you're not infectious.

One nurse has chosen to challenge the decision to quarantine her, and one doctor has made a decision to remain in his house during the incubation period. We're talking about two individuals, I don't think that's generalizable to all nurses and all physicians.

I still support Kaci Hickox' decision to challenge the quarantine, and a judge has ruled in her favor.

No opinion one way or the other, just an observation.

I find it interesting that the doctors come back and do it and don't complain.

Stanford doctor in Ebola quarantine in Bay Area - SFGate

"Dr. Colin Bucks hasn’t had close physical contact with another human being since Sept. 21 and he won’t for another two weeks, when his quarantine period ends after his return from the Ebola front lines in Liberia.

He arrived shortly after news broke that a doctor returning from West Africa had been diagnosed with Ebola in New York City, and just hours before a nurse flew into Liberty International Airport in Newark, N.J., and was forcibly quarantined for several days.

He talked to San Mateo County public health officials and agreed to quarantine himself — a decision he’d already made while he was still working in Liberia.

I miss my family,” Bucks, 43, said Thursday from his Redwood City home. “But we recognized in advance that it would be essential to be separated on the return. It’s an extension of the deployment to me."

[MissyWrite]

I have a question for those here who favor quarantine, that has so far gone unanswered:

Dr. Craig Spencer is hospitalized with Ebola in NYC. The nurses and doctors caring for him are not quarantined. At the end of their workday, they go out into the general public. They ride the subway, go to restaurants, go bowling, and live normal lives. They've been doing this for weeks. Many people are clamoring for the mandatory quarantine of any health worker who has had contact with an Ebola patient, but no one is clamoring for the quarantine of these particular health workers.

Why is that?

[Mulan]

Doctors Spar With Congress Over Ebola Worker Quarantine - Bloomberg

"In contrast to Doctors Without Borders, the aid group Samaritan's Purse started quarantining all its volunteers upon their return from West Africa since Kent Brantly, a group-sponsored doctor, contracted Ebola in Liberia in August, said Franklin Graham, president of the North Carolina charitable group. About 30 volunteers have gone through quarantine since then at an undisclosed location within an hour of one of four U.S. hospitals specially trained to handle Ebola patients, he said."

[OCNRN63, RN]

Doctors Spar With Congress Over Ebola Worker Quarantine - Bloomberg

"In contrast to Doctors Without Borders, the aid group Samaritan’s Purse started quarantining all its volunteers upon their return from West Africa since Kent Brantly, a group-sponsored doctor, contracted Ebola in Liberia in August, said Franklin Graham, president of the North Carolina charitable group. About 30 volunteers have gone through quarantine since then at an undisclosed location within an hour of one of four U.S. hospitals specially trained to handle Ebola patients, he said."

​And that was a decision the organization made, not one that was foisted upon them by politicians looking for good sound bites.

[RNsRWe, ASN, RN]

I'm still struggling to understand the logic put forth on this topic where flu vaccines and ebola have crossed paths.

I cannot understand how someone can insist on quarantine for an asymptomatic, non-infectious person who had PPE-protected contact with someone with Ebola within the last 3 weeks......AND YET insist she does not need a flu shot, because she will "know" that she's ABOUT to become infectious if/when she contracts a preventable illness that is very easy to spread even before one knows she is infected?!?

[MissyWrite]

I have a question for those here who favor quarantine, that has so far gone unanswered:

Dr. Craig Spencer is hospitalized with Ebola in NYC. The nurses and doctors caring for him are not quarantined. At the end of their workday, they go out into the general public. They ride the subway, go to restaurants, go bowling, and live normal lives. They've been doing this for weeks. Many people are clamoring for the mandatory quarantine of any health worker who has had contact with an Ebola patient, but no one is clamoring for the quarantine of these particular health workers.

Why is that?

***

Sine no one else has answered this question after numerous posts over 2 weeks, I will answer it myself:

1. I never even thought about it. Like, it never even crossed my mind.

2. It hits too close to home. After all, it could be ME who cares for an Ebola patient and is then quarantined. Who would take care of my kids? My dog? Where the heck would they put me, in a tent with a stinky porta-potty? No way! Even if they locked me up in my own home, my name would be all over the media so I probably couldn't even get a pizza delivered! I have rights, you know?

3. Dr. Spencer's nurses are here in America, not Africa. We have the best and most modern health system in the world, so his nurses won't spread it because they won't catch it. Those two nurses in Dallas? They were just a fluke. Yes, yes, I know PPE is only as good as the technique in removing it, but I'm sure they're doing a fine job. Let's talk about something else, OK? Let's talk about the selfish, arrogant health workers who don't give a crumb about anyone but themselves -- Kaci Hickox and Craig Spencer! That's the real issue!

4. Govs. Christie and Coumo haven't yet given me the opinion I should have. In fact when they were asked this very question, they were 'dumbfounded' and could not give any meaningful answer.

5. Yeah, yeah, I know Ebola is Ebola is Ebola, but this is just......different.

***If anyone in favor of the quarantine does not fall within one of the categories above, let us know what YOUR answer is.

Thank you.

[RNsRWe, ASN, RN]

***

Sine no one else has answered this question after numerous posts over 2 weeks, I will answer it myself:

1. I never even thought about it. Like, it never even crossed my mind.

2. It hits too close to home. After all, it could be ME who cares for an Ebola patient and is then quarantined. Who would take care of my kids? My dog? Where the heck would they put me, in a tent with a stinky porta-potty? No way! Even if they locked me up in my own home, my name would be all over the media so I probably couldn't even get a pizza delivered! I have rights, you know?

3. Dr. Spencer's nurses are here in America, not Africa. We have the best and most modern health system in the world, so his nurses won't spread it because they won't catch it. Those two nurses in Dallas? They were just a fluke. Yes, yes, I know PPE is only as good as the technique in removing it, but I'm sure they're doing a fine job. Let's talk about something else, OK? Let's talk about the selfish, arrogant health workers who don't give a crumb about anyone but themselves -- Kaci Hickox and Craig Spencer! That's the real issue!

4. Govs. Christie and Coumo haven't yet given me the opinion I should have. In fact when they were asked this very question, they were 'dumbfounded' and could not give any meaningful answer.

5. Yeah, yeah, I know Ebola is Ebola is Ebola, but this is just......different.

***If anyone in favor of the quarantine does not fall within one of the categories above, let us know what YOUR answer is.

Thank you.

I've posed this question every time someone at work starts talking about "that nurse with Ebola in Maine". And every time, I get a look of "hmmm, never thought of that" and it's usually followed by "I never thought of it that way".

But no answer as to why there should not be the same standard across the board.